Welcome to “Ask Debbie,” where I answer some frequently asked questions regarding home healthcare coverage and services.
My 88-year-old father is in a nursing home after having a stroke. He wants to go back to his home but needs help. What do we need to do to plan for his return home?
Talk to the social worker/discharge planner at the nursing home (NH) and develop a discharge plan and timeframe. Almost anyone discharged from a nursing home qualifies for home care. A nurse, home health aide for bathing assistance and physical or occupational therapy can provide care upon return home. Equipment such as a hospital bed, wheelchair or walker, bedside commode or lift chair may need to be ordered. The discharge planner and therapist in the NH can assist in identifying needed items and home delivery. Additional private-duty homemakers/companions/ CNAs are also available (from four to 24 hours per day), but these services are not covered by Medicare.
I have a neighbor who has been very ill recently. I was asked to arrange home care for him. How do I go about this?
Call your home healthcare provider with your neighbor’s name, address and telephone number. Explain what problems your neighbor is having, and the agency will call the doctor for approval to go and evaluate your neighbor.
My husband was discharged from a hospital over the weekend. I thought he needed to have home care, but on the weekend, no one was there to arrange it. What should I have done?
Anyone going home from the hospital or nursing home who has Medicare and is homebound (except for going to their doctor appointments, etc.) should have a skilled need which qualifies them for home care. Call home care anytime—in our office, there is a HEALTHnurse on call on weekends who can arrange home care if certain criteria are met and a physician order is given.
I have stayed in a nursing home on the Medicare floor for the past three weeks. My Medicare coverage is up and I will return home soon. Does this mean I can’t have home care covered by Medicare upon discharge?
You would start over regarding Medicare coverage for home care. With a doctor’s order, home care can start the day after your arrival home. Nursing home coverage and home care Medicare coverage are not related.
Is there a limit to the number of times a person can receive home healthcare services in one year? My neighbor received home healthcare visits three months ago after a fractured hip repair. Recently, she was sick with the flu which later turned into pneumonia. Could home healthcare services be started again?
With her doctor’s order, home healthcare services can be restarted. Even though she was discharged from home healthcare services after the hip fracture episode, she now has a new problem for which she qualifies for home healthcare services again. There is no limit to the number days or times a Medicare recipient can receive home healthcare services in any given year. The qualifications for Medicare home care include a skilled need for nursing and/or therapy, a doctor’s order and the necessity to remain homebound while receiving services.
Are there any medical conditions for which Medicare coverage continues longer than a few weeks or months?
For people who have a Foley catheter, Medicare covers catheter changes as ordered by the patient’s doctor, and often, a home health aide to assist with bathing and grooming.
Pernicious anemia and other blood problems requiring monthly vitamin B12 injections are also covered. A home health aide is often covered as well. Medicare requires the patient to be primarily homebound and the doctor must order services. TPW
The owner of Home Health Care Plus, Inc. in Pekin, Debbie Davison is a registered nurse and holds a master’s degree in nursing. The Medicare- certified company has been serving clients and their families in central Illinois since 1994. For more information visit www.homehealthcareplus.net or call 353-7300.